Teaching and Learning with Simulation Environments

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“Medical students want to focus experiential learning on preparing for the future.”

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A narrative (movie) of reality (in Literature, novels are seen often as photographs of reality).

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Third way of doing science, in contrast to both deduction and induction.

An effective tool for discovering surprising consequences of simple assumptions.

Instructional scenario, an environment and a method of training students and teachers.

A form of experiential learning.A game, role-play, and activity that acts as

a metaphor.

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“Simulation means driving a model of a system with suitable inputs and observing corresponding outputs” (Bratley, Fox and Schrage, 1987).

Purposes: prediction, performance, training, entertainment, education, proof

and discovery.

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Simulation lies in prediction, proof and discovery.

In Social Sciences, the aim is to discover important relationships and principles from very simple models.

The more simple the model, the easier it may be to discover and understand the subtle effects of its hypothesized mechanisms.

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Induction is the discovery of patterns in empirical data. Example: analysis of opinion surveys and the macro-economic data.

Deduction involves specifying a set of axioms and proving consequences that can be derived from those assumptions.

The discovery of equilibrium results in game theory using rational choice axioms and it is a good example of deduction.

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Like deduction, it starts with a set of explicit assumptions. But unlike deduction, it does not prove theorems. Instead, a simulation generates data that can be analyzed inductively. Unlike typical induction, the simulated data comes from a rigorously specified set of rules rather than direct measurement of the real world. While induction can be used to find patterns in data, and deduction can be used to find consequences of assumptions, simulation can be used as an aid in intuition.

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Simulation is a way of doing thought experiments. While the assumptions may be simple, the consequences may not be at all obvious.

The large-scale effects of locally interacting agents are called “emergent properties” of the system. When the agents use adaptive rather than optimizing strategies, deducing the consequences is often impossible; simulation becomes necessary.

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Promote the use of critical and evaluative thinking.

Support concept attainment through experiential practice.

Help students appreciate more deeply the management of health care (diagnostics).

Reinforce other skills, such as debating, critical thinking, and research.

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Simulations are cheaper to create than real life counterparts.

They are easy to construct.They remove an element of danger

from the situation.They can be paused, whereas real

life cannot. Pausing allows more time for students to assess what´s going on.

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Resources and time are required to develop quality learning experience.

Simulated experiences are more realistic than some other techniques and they can be so engaging and absorbing that students forget the educational purpose of the exercise.

It has an element of competition, yet the aim is not win, but to acquire knowledge and understanding.

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Prepare the case studies in advance as much as possible.

Monitor the process closely: Are the desired instructional outcomes well

defined? Does the student demonstrate an understanding

of his/her role? Are problem-solving techniques in evidence? Will follow-up activities be necessary? Does it offer a suitable measure of realism for

the group? Consider what to assess.

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Simulations provide multiple chances to practice, including making attempts with higher risks and failures, and to learn, retry, and master new skills faster and with less effort than through experiences not mediated by computers.

Stimulate development of heuristic skills in teachers.

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The goal of advancing technologies in education can be achieved through creative application of education simulators.

Online learning environments link pedagogy, technology and the learner need.

Systemic challenges of teacher education include fundamental conceptions of teaching and learning, organization of knowledge, assessment practices and results, and engagement of a global community practice.

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This shift is based on self-direction and personal validation, in a complex yet repeatable practice environment.

It is supported by emerging interdisciplinary knowledge coming from fields such as Cognitive Science and Complexity Science. AI and Neurosciences are today at the front line supporting the revolution of MOOC´s for universal higher education.

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They simulate an activity that is “real”. They are “hands-on”, involving

students, so they become participants, not mere listeners or observers. Students learn better from their own experiences than having others´ experiences related to them.

They are motivators for learning. Student involvement in the activity is so deep that interest in learning, and along its subject matter develops.

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They are tailored to the student. When simulations are designed specifically for their audience, they can take development requirements into consideration.

They are inspirational. Student input is welcome and activities are designed to encourage students to enhance the activity by contributing their own ideas.

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They are developmentally valid. Simulations take into account the students´ developmental level.

They are empowering. Students take on responsible roles, find ways to succeed, and develop problem solving tools as a result of the interaction.

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A Computer-Based Educational simulation has 3 components:

1) A data model or set of algorithms that can be manipulated by the learner and provides dynamic feedback based on those manipulations.

2) A role for the learner to adopt. 3) An objective to achieve, or set of tasks

to complete, using the data model.21

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Once the exercise is completed, a debriefing is also necessary to fully assess and go through what happened, and ascertain student comments and reactions to the experience.

Simulation issues, processes and outcomes can then be linked to course concepts and learning objectives.

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Improved student awareness of a topic or a subject.

Real-world and practical application of course concepts.

Enhanced analytical ability to resolve issues and problems in the subject matter.

Increased exposure to complex real-life experiences.

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1) Integrating seemingly disparate topics that have definable relationships.2) Learning a system or model of concepts through experimentation.3) Practicing difficult, rare, or dangerous tasks.4) Decision-making and prioritizing.5) Working with ambiguity.

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Dynamic of epidemic diseases (non linear and stochastic processes): generation measles.

Mathematic model: Kermack-McKendrick equation with Susceptible S(t), Infective I(t), e Removed R(t).

dS/dt=-rSI, dI/dt=rSI-pI, dR/dt=pI Environment: 2D grid Agents: blue (susceptible), red

(infective); memory of family, work place.

Population of agents: variable size.27

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Arab Spring (2011) + SNs: strong connectivity of tweets

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Simulations are one way to incorporate an innovative use of technology into the learning environment.

Technology is not needed for the creation or administration of a simulation but it can enhance the overall presence and impact of the simulation for students.

Start with an easy and simple tool, such as NetLogo, before going to Repast or Mason.

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Learn the Logo language by looking to small programs and running them. Later on, you can be inspired to copy parts of them.

The interface is simple, but you must learn how to complicate it, by transforming into a dashboard, with fixed areas apart the window where the experiences are to be observed.

Two areas are necessary, the control one (command of variables) and the dedicated to display graphics of the all measurements.

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Run Conway´s Game of Life in NetLogo. Be confident, and face the task of

development process. It is a difficult one, but without this exercise you don´t feel at easy. Remember you must think about creating a simulation from start to finish.

This activity, rather than follow a linear step-by-step approach, require students to be involved, creative and innovative, as well as anticipate problems and solutions.

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Instead of just implementing something that had already been developed, be responsible for the development: a different approach to learning than most of the students are used to!

By using simulations to enhance traditional teaching and learning, there is an opportunity to participate in active learning.

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Keep it simple (KISS).Encourage technology-related

professional development, in order student feel at easy with the tools.

The learning outcome is: the more they view technology as an effective classroom tool for 1) analyzing info, 2) addressing critical thinking skills, and 3) learning new concepts.

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Repetitive performance of intended cognitive or psychomotor skills in focused domain coupled with rigorous skills assessment, that provide learners specific, informative feedback, that results in increasingly better skills performance, in a controlled setting.

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Inherently reductionist – you can´t model everything.

Require a commitment to discovery-oriented learning and related support.

More work to create than most other types of educational technology (creation of a model).

More difficult to evaluate what students learn than many other types of educational technology (need of evaluation methods).

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The use of simulators for clinical skills training increased because:

Simulation has been defined as a situation in which a particular set of conditions is created artificially in order to study or experience something that is possible in real life.

Simulator is a device that enables the operator to reproduce or represent, under test conditions, phenomena likely to occur in actual performance.

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Simulation based medical education can be defined as any educational activity that utilizes simulative aides to replicate clinical scenarios. Simulation tools serve as an alternative to the real patient.

Apprentices can make mistakes and learn from them without the fear of distressing the patient.

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Low-fidelity: static, and lack the realism or situation context. They are used to teach novices basics of technical skills. Example: intravenous insertion arm.

Moderate-fidelity: resemblance of reality with features as pulse, heart sounds and breathing sounds, but without the ability to talk and they lack chest or eye movements.

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They can be used for both the introduction and deeper understanding of specific complex competencies. Example: cardiology.

High-fidelity: for intervention with computers that drive manikins to produce physical signs and feed physiological signs to monitors. They resemble reality, by talking,breathing, blinking and respond to physical and pharmacological interventions. Example: a human patient, obstetric case study.

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Computer-based simulations have a history as long as the development of the computer.

The technique of using simulations for teaching and learning start when students faced solving problems, through role play and the use of data.

The use of simulations in education allow the possibility of dynamic discovery-oriented learning.

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Team training emergency.From self to social cognition.Patient simulation as social practice. Identifying and training non-

technical skill for teams in acute medicine.

Discrete-event in health care clinics.Measuring team performance in

simulation-based training.47

Medicine Simulation Center: Medical training facility that incorporates

5 types of simulation, including:▪ Standardized patients and teaching

associates.▪ Human patient simulation.▪ Virtual reality.▪ Task trainers.▪ Computerized simulation.

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On disease dynamics: spread of influenza through a population.

The Lancet, Vol. 384, Special Issue, S20, 19 November, 2014.

“Effects of social networks on disease dynamics of influenza through a population”.

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MOOC´s: Interdisciplinary Course on “Medical Education in the New Millennium”.

Platform: Stanford Open EdX. Course topic: Medicine & Health. Speakers: Daphne Koller (founder of

Coursera) et al. Structure: Eleven week Course includes

discussions, virtual reality, simulation, cognitive views, ...

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Biological simulation.Medical simulation.Construction management

simulation.

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InfoTech – Medical simulationwww2.technologyreview.com/

spotlight/infotech/?a=1

Healthcare Modeling and Simulation.

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Flaminio Squazzoni and Niccolò Casnici:

“Is Social Simulation a Social Science Outstation? A Bibliometric Analysis of the Impact of JASSS”, JASSS, Vol. 16 (1), 10, 2013.

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